Legal Battle Overview
CMS challenges a court ruling requiring increased Medicare Advantage star ratings for UnitedHealthcare’s 2025 plans, filing an appeal on January 21st without stating specific grounds.
Initial Lawsuit Details
UnitedHealthcare contested the inclusion of secret-shopper calls in their ratings through a September lawsuit in Texas District Court, claiming procedural violations.
Court Decision Impact
Judge Kernodle’s November ruling favored UnitedHealthcare, mandating CMS to recalculate ratings without the disputed assessment, leading to improved scores for both UnitedHealthcare and Centene contracts.
Ongoing Developments
The appeal marks continued disagreement over Medicare Advantage rating methodology, with potential implications for future assessment procedures.
Discover the latest payers’ news updates with a single click. Follow DistilINFO HealthPlan and stay ahead with updates. Join our community today!
